9705-108 (CGAR)LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of
Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
N6fessionals Code, and my License is in full force and effect.
License # Lic. Class Exp. Date
Date
675297
A
Signature of Contractor
OWNER -BUILDER DECLARATION
8/31/97
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the following reason:
( ) I, as owner of the property, or my employees with wages as their sole
compensation, will do the work, and the structure is not intended or offered for
sale (Sec. 7044, Business & Professionals Code).
( ) I, as owner of the property, am exclusively contracting with licensed
contractors to construct the project (Sec. 7044, Business & Professionals
Code).
( ) I am exempt under Section , B&P.C. for this reason
Date Signature of Owner
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
( ) I have and will maintain a certificate of consent to self -insure for workers'
compensation, as provided for by Section 3700 of the Labor Code, for "the
performance of the work for which this permit is issued.
4 1 have and will maintain workers' compensation insurance, as required by
Section 3700 of the Labor Code, for the performance of the work for which this
permit is issued. My workers' compensation insurance carrier & policy no. are:
Carrier Policy No.
(This section need not be completed if the permit valuation is for $100.00 or less):
( ) I certify that in the performance of the work for which this permit is issued,
I shall not employ any person in any manner so as to become subject to the
workers' compensation laws of California, and agree that if I should become
subject to the workers' compensation provisions of Section 3700 of the,Labor
An
de, I shall forthwith comply with t ose provisions te: H- �rt�� Applicant .//
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $100,000, in
addition to the cost of compensation, damages as provided for in Section 3706
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety.
for a permit subject to the conditions and restrictions set forth on hiL
application.
1. Each person upon whose behalf this application is made & each person at
Who se request and for whose benefit work is performed under or pursuant to
any permit issued as a result of this applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
2. Any permit issued as a result of this application becomes null and void if
work is not commenced within 180 days from date of issuance of such
permit, or cessation of work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is
correct. I agree to comply with all City, and State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon
th above-mentioned property forCinspection/purposes. %
Signature (Owner/Agent �-- -=�'� 1 /✓--;Date/ tI �+ +'
BUILDINGPERMITPERMIT# CONTROLS
.
97fkr- 108 5242
DATE /✓/+�7 VALUATION LOT *A �
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JOB SITS
APN
ADDRESS 79-1,40 C"ALLl;'1�XM#' O
769-00-042
OWNER
CONTRACTOR / DESIGNER / ENGINEER
LA QUINIA N•i WC;AL CUMNUPLAlA
fNrRCrEtATED RFSt-)IJRCwS 1 N C
.1332 PARK VIEW AVE.#140
2649'iC7WN�"r1V1'� .illi flfii;U
MANHA'1TAN BEACH CA 9(.
WN.SrIL K VILLMIE CA 91361
1.905)4976030 CRT.! 4737
USE OF PERMIT
4 i<A kA0
t-M,F f,.f�. i;11tZ11�Ca1{.')dsNc'i,+JSt3fili t
VAi.i)ri.`I'ION 3,250kO LS
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DA 1r'% LESS PRE -4 AOD FU" S
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T0,111,81 04111dAi1'!' 1i`i+,EN OUFS NOW
U.1.04)
JUN p 6 1997.
CITyriclk.i •
RECEIPT r I BY DA E INSPECTOR
R
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K to Wrap
F.A.U.
Framing
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
POOLS - SPAS
BLOCKWALL APPROVALS
steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Pibg. Test
Final
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
Appliances
Final
COMMENTS:
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
E'herior Receptacles
Smoke Detectors
16p. Use of Power
Final
Utility Notice (Perm)
SPECIFICATIONS.
EXHIBIT "A" 11
Job Address: Plaza Tampico
78-140 Calle Tampico
La Quinta, Ca.
Owner: Laeroc Partners - Bill Rack
The following are the final specifications for the above referenced project. The purpose of this document is
to provide the specific details regarding the scope of work, type of materials utilized, projected time frame
and contract exclusions. The specifications contained herein are in support of our proposal that was
provided to you dated 12-13-96. We received confinnation from you on 12-19-96 instructing us to proceed
with option #2 said proposal.
Exclusions:
Any and all blueprints, designs and engineering that may be required by the local authorities for the purpose
of obtaining any necessary permits are the sole responsibility of the owner and are not included within the
scope of this contract.
The owner shall be responsible for obtaining and providing the contractor with any and all necessary
building permits or licensesrequired by the local governing authority. Any and all fees or expenses payable
for said building permits, licenses, plan check etc. shall be the sole burden of the owner and are not
included within the scope of this contract.
No grading, staking, paving, surveying, bonds, cepeas, or engineering. Owner has the responsibility to
notify the contractor of any known underground service lines.
The owner shall have the responsibility of tenant notifications and alternative parking arrangements during
the construction period.
nclusions within the "Scone of Work":
Contractor shall order and coordinate the fabrication, delivery and installation of the required materials
contained within the "Scope of Work" after receipt of any and all related permits and licenses required by
the governing authorities, and payment of the required contract deposit check in the amount of $1,000.00
Install 130 L.F. of ornamental iron fence 8'-0" high. Fence panels to be constructed of 1 1/2" x 1 1/2"
` 14 gauge rails on the top & bottom, with 3/4" x 3/4" 16 gauge pickets every 4 3/4" on center.
Fence panels to be attached to 2"'x 2" 11 gauge line post placed in native soils, imbedded'in to concrete
24" deep by 10" in diameter. Top of footings shall extend 4" above the finished grade on areas where line
post would be in direct contact with native soils, and finished level to grade on areas currently paved.
Install 10 Ea. ornamental iron gates 8'-0" high in to 9'-0" wide openings at parking stalls. Gate panels to be
constructed of 2" x 2" 14 gauge rails on top, bottom and sides with 3/4" x 3/4" 16 gauge pickets every
4 3/4" on center, and a 2" x 3/16" flat stock truss per the plan, attached to gate post via 2 Ea. 4" x 4" butt
hinges with lockable fork latch on opposite side.
Install 4" x 4", 1/4" wall iron gate post placed in native soils, imbedded in to concrete 36" deep by 12" in
diameter. Top of footings shall extend 2" above the finished grade on areas where line post would be in
direct contact with native soils, and finished.level to grade on. areas-currt::ntiv•payed. .
In 4" x 4", 1/4" wall iron latch post placed in native soils, imbedded in to concrete 36" deep by 12" in
diameter. Top of footings shall extend 2" above the finished grade on areas where line post would be in
direct contact with native soils, and finished level to grade on areas currently paved.
All above materials to have a powder coat finish, color to be selected by owner from the color chart
provided by the contractor.
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Pierce Construction POST & CONCRETE FOOTINGS Pierce Construction..
28402 N. Fig Court ,r+crgrr
Santa.Clarita, CA 973
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PICKETS: 314' SO.T. I6Gk iD 4 WO C..
TRUSS: Y X 3016' FLAT STOCK
4'80Tf HINGES
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Why Choose Powder Coa_ tine?
incressin;lT stringent enrironnleatal reRviatioes, rising costs is all areas. and
demands by consumers for better Quality, more durable products. are Smoot
the challenges faciaQ today's tlolsher. Powder coating providessolutioa to
these challeoltes and others.
Quality : Powder costings are itiZblr durable with
improved corrosion resistance.
Ea ironmentat ,
Responsibility: Powder coatings compiv with environments[
regulations for cnlient etaission and eliminate.
bazardous waste clisposal.
Economy: Overspreyed potivder Stay be tAptnrtxi and
resprayed for of mall marerinl nsuge in excess
6,1795% Powder reduces energy noosumptio»
and waste remot,11 costs.
1_
Efficiency': Powder tvpicaU.~provides an acceptable
coating with only one apptieatioo. Powder
reduces rejection rates and typically increases
Production rates.
Convenience: Powder ie supplied'resdT to spray; it requirr-s
no miaiog.
* Simplicity: Pow•cier it Priv to apply. simplifying the
coating process and operator training. ,
Comfort: Powder Provides a safer.-more acceptable
environment for operators and other workem •
Costs: Powder coatin' delivers a high quality finish
and helps make ynvroperatio» more PIACifat
and cost effective.
a SLI..rr= >_r 000*S.eta�
Pierce Constr=tion Powder Coating �� Pierce Ccnstr=tior.
26402 N. Fig Court w
Santa Clarita, CA 973
M ..nIMs �waiD ter i a ti Na
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�f - { 12-27-%. twotw
-i 05-30-1997 01:39PM FROM IRMI TO 917007777155 P.02
Integrtited Resources, Inc.
Architectural., Engineering & Environmental Consultants.
Facsimile Transmittal
TO: CHRISTY— PLA1VNI.N'G DEPT. COMPANY CITY OF LA QUINTA
FAX NO. 760-777-7155 PHONE NO.
FROM. Dan Pierce
F.4X N0. (805)4971_6360 PHONE NO.. (805) 497-6030
e-mail'www.dan u. integratedresources.com
DATESENT._5-31-97 REC'EIPTCONFIRMATIONREQUE9TEX .X M NO
COMMENTS. RE., 78-140 (A LLE T.41l1PICO — MODIFICATION TO THE
APPROVED PLAN
CHRISTY,
PER OUR CONVERSATION, PLEASE REVIEW THE ATTACHED "FLOOR
PLAN' NOTE THE INCREASE SPACE IN THE EASTERLY FIVE ;PARKING
STALLS: THIS REVISION WILL SOME WHA T.MITIGATE .THE POTENTIAL OF .
A . VEHICLE HITTING THE FENCE, ONCE INSTALLED. IN ADDITION IT. MLI:'
MAINTAIN A CONSISTENT FENCE LINE & MMKE FOR A. TIGHTER LOOKING .
PRODUCT
PLEASE CONTACT ME A.S.A.P. SHOULD YOU DETERkIINE THAT THIS
DESIGN IMPROVEMENT IS UIVACCEPTARLE.
HA VE A GREAT DA Y!
DAN PIERCE
Total Alumber of Pages Transmitted, including this cover
page; �
2649 Towrisgate Road; Suite 600, Westlake 6 tillage, California 91361
TOTAL P.O2
05-30-1997 01:30PM FROM IRMI
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